Rise of High-Cost Insurance Claims Elevate Need to Mitigate Financial Risks, according to QBE North America's Accident & Health Market Report

Rhea-AI Summary

QBE North America (OTC:QBIEY) has released its 2025 Accident & Health Market Report, revealing significant increases in high-cost insurance claims. The report highlights that circulatory claims frequency has risen nearly 60% post-COVID, while neoplasms remain the primary excess loss claim across all deductible levels.

The report identifies several critical trends, including escalating preterm birth claims reaching nearly $4 million in 2024, increased prevalence of circulatory disease among younger patients, and growing impact of specialty pharmaceuticals. QBE North America, which reported Gross Written Premiums of $7.3 billion in 2024, has expanded its offerings to include specialized stop loss solutions for organ transplant coverage, Taft-Hartley, multi-employer and union health plans.

The company emphasizes the importance of stop loss insurance as a risk management tool for self-funded employers, particularly in light of emerging legislative challenges to ERISA and record-breaking approvals for cell and gene therapies.

Positive

• Gross Written Premiums reached $7.3 billion in 2024
• Expanded offerings including specialized stop loss solutions
• Enhanced coverage options for organ transplant, Taft-Hartley, and multi-employer plans
• Introduction of group medical stop loss captives for better cost control

Negative

• Circulatory claims frequency increased by 60% post-COVID
• Preterm birth claims severity escalating to nearly $4 million
• Growing strain on patient affordability due to specialty pharmaceuticals
• Emerging legislative challenges to ERISA affecting self-funded health plans

NEW YORK, July 1, 2025 /PRNewswire/ -- QBE North America today announced the release of its 2025 Accident & Health Market Report, offering timely analysis of the cost drivers and trends shaping self-funded healthcare plans. Based on proprietary claims data and industry research, the report highlights the growing complexity of healthcare claims, with cancer, circulatory disease and premature births among the most significant contributors to high-cost cases.

"As treatment options grow more advanced and costly, employers are facing rising pressure to control volatility in their self-funded healthcare plans," said Tara Krauss, President of Accident & Health at QBE North America. "Our goal is to equip brokers, administrators and employers with actionable insights to navigate these changes with confidence."

The report shows the frequency of circulatory claims has risen almost 60% post-COVID and neoplasms continue to be the predominant excess loss claim across all deductible levels. Additionally, the severity of preterm birth claims continues to escalate, with some cases reaching close to $4 million in 2024.

Key themes explored in the 2025 report include:

• Increased prevalence of circulatory disease rates post-COVID, particularly among younger patients, is a significant concern
• Emerging high-cost claim trends, including million-dollar claims for cancer, circulatory conditions and pre-term births
• Growing impact of specialty pharmaceuticals and continued strain on patient affordability
• Record-breaking cell and gene therapy approvals, with advanced treatment options for autoimmune diseases and rare genetic conditions
• Societal factors that could be driving the health crisis in America such as antibiotic overuse and processed food consumption
• Legislative challenges to ERISA, as several states introduce bills targeting self-funded health plans

This year's report also highlights QBE's expanded offerings, including tailored stop loss solutions for organ transplant coverage, Taft-Hartley, multi-employer and union health plans, and continued momentum in group medical stop loss captives, which provide greater stability and cost control for policyholders.

"As the healthcare landscape continues to shift, stop loss insurance remains a critical tool for employers looking to manage risk and protect their plan assets," Krauss added. "Our annual report reinforces QBE's commitment to supporting self-funded employers with data-driven solutions and trusted expertise."

About QBE North America

QBE North America is a global insurance leader helping customers solve unique risks, so they can stay focused on their future. Part of QBE Insurance Group Limited, QBE North America reported Gross Written Premiums in 2024 of $7.3 billion. QBE Insurance Group's results can be found at qbe.com. Headquartered in Sydney, Australia, QBE operates out of 26 countries around the globe, with a presence in every key insurance market. The North America division, headquartered in New York, conducts business primarily through its insurance company subsidiaries. The actual terms and conditions of any insurance coverage are subject to the language of the policies as issued. Additional information can be found at qbe.com/us or follow QBE North America on LinkedIn, Facebook and Instagram.

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SOURCE QBE North America

FAQ

What are the key findings of QBE North America's 2025 Accident & Health Market Report?

The report reveals a 60% increase in circulatory claims post-COVID, neoplasms as the primary excess loss claim, and preterm birth claims reaching nearly $4 million in 2024.

How much did QBE North America (QBIEY) report in Gross Written Premiums for 2024?

QBE North America reported Gross Written Premiums of $7.3 billion in 2024.

What new solutions has QBE introduced to address rising healthcare costs?

QBE has introduced specialized stop loss solutions for organ transplant coverage, Taft-Hartley, multi-employer and union health plans, and group medical stop loss captives.

What are the main factors driving high-cost insurance claims according to QBE's 2025 report?

The main factors include cancer, circulatory disease, premature births, specialty pharmaceuticals, and advanced cell and gene therapies.

What challenges are affecting self-funded healthcare plans in 2025?

Key challenges include rising treatment costs, increased circulatory disease rates, specialty pharmaceutical expenses, and legislative challenges to ERISA affecting self-funded health plans.